And use of sleeping pills has skyrocketed. A study this year in the journal Health Affairs found a 50% jump in sleeping pill use -- from 5,445 people per 100,000 in 1998 to 8,194 per 100,000 people in 2006. Though one version of Ambien, a popular sleep aid, is now available as a lower-cost generic costing about 50 cents per pill, newer drugs such as Rozerem and Lunesta cost about $4 and $5 per pill, respectively, or a minimum of nearly $1,500 per year for patients who take a sleeping pill every night. Online behavioral therapy programs cost less than $40 per user, and face-to-face counseling can range from about $300 to $1,800, depending on how many sessions a patient goes through and what level of specialist, from social worker to psychiatrist, provides the therapy.
Counting sheep but no sleep?
Cognitive behavior therapy -- offered online by insurers -- is more effective than pills, an expert says.
MEDICINE
For The Record
Los Angeles Times Friday, December 19, 2008 Home Edition Main News Part A Page 2 National Desk 1 inches; 53 words Type of Material: Correction
Insomnia treatment: An article in the Nov. 3 Health section about online therapy for insomnia was incorrect in saying that a blog for the annual meeting of the American Academy of Sleep Medicine did not refer to the therapy. The blog did in fact refer to a study about online therapy for insomnia.
For The Record
Los Angeles Times Monday, December 22, 2008 Home Edition Health Part F Page 5 Features Desk 1 inches; 53 words Type of Material: Correction
Insomnia treatment: An article in the Nov. 3 Health section about online therapy for insomnia was incorrect in saying that a blog for the annual meeting of the American Academy of Sleep Medicine did not refer to the therapy. The blog did in fact refer to a study about online therapy for insomnia.
Unlike sleeping pills, counseling is usually a one-time thing and costs do not continue year to year.
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Sleep-related fears
Cognitive behavior therapy has been in use for decades and is part of the American Academy of Sleep Medicine's clinical guidelines for treating insomnia. "The only problem with CBT is that there are not nearly enough trained practitioners in the U.S. to help the millions of people with insomnia," says Dr. Michael Sateia, head of the sleep medicine program at Dartmouth-Hitchcock Medical Center in Lebanon, N.H., and a former president of the American Academy of Sleep Medicine.
During cognitive behavior therapy, trained specialists work with people who have insomnia to eliminate their sleep-related fears and misconceptions. Some such worries are so encompassing that people simply can't sleep.
The therapy may include sleep-restriction exercises to encourage drowsiness and stimulus control. An example of the latter would be not going downstairs upon leaving the bed because a return up the stairs could increase wakefulness, says Lynelle Schneeberg, an insomnia therapist at Gaylord Hospital. The therapy can also include so-called sleep hygiene strategies that can help promote shut-eye, such as forgoing alcohol and exercise in the hours before bed and using the bedroom only for sleep and sex.
"Many people 'catastrophize' their inability to fall asleep -- they lie there and tell themselves over and over that they won't fall asleep -- and then they don't," Sateia says. "By using behavioral changes, we can help them understand that no disaster will occur if they don't fall asleep and encourage them to think and do other things rather than lie there anxiously."
